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This is VAERS ID 275559

Case Details

VAERS ID: 275559 (history)  
Age: 12.0  
Gender: Female  
Location: Pennsylvania  
Vaccinated:2007-03-26
Onset:2007-03-27
   Days after vaccination:1
Submitted: 2007-04-03
   Days after onset:7
Entered: 2007-04-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0186U / 0 RA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B009AA / 0 LA / IM

Administered by: Private       Purchased by: Public
Symptoms: Rash papular
SMQs:, Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: nickel and lactose allergies
Diagnostic Lab Data: none
CDC Split Type:

Write-up: patient developed a skin collored papular nonpruritic rash on arms and face 5 days after receiving hpv and tdap vaccines. came to the doctors to be evalauted for the rash. no other symptoms or sequelae


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